| NPI | 1972792844 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WA MD60086259) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MD427100) |
| Enumeration Date | 2007-10-17 |
| Last Update Date | 2020-08-25 |