| NPI | 1043371909 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WA MD60147167) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL TRN7958) |
| 207XS0106X Orthopaedic Surgery, Hand Surgery (Licence: WA MD60147167) | |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: WA MD60147167) | |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2012-02-23 |