| NPI | 1003082017 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WA MD60170138) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MA 222521) |
| Enumeration Date | 2008-04-30 |
| Last Update Date | 2011-11-08 |