| NPI | 1972008373 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: ID M-17771) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WA MD61416009) |
| 207XX0801X Orthopaedic Surgery Orthopaedic Trauma (Licence: WA MD61416009) | |
| Enumeration Date | 2018-03-27 |
| Last Update Date | 2024-07-09 |