| NPI | 1952633810 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NM mD2017-0939) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: SC 40073) |
| 207X00000X Orthopaedic Surgery (Licence: WA MD60372855) | |
| Enumeration Date | 2010-02-03 |
| Last Update Date | 2023-11-14 |