| NPI | 1063440048 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WA OP60210160) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA OS010378L) |
| Enumeration Date | 2006-06-29 |
| Last Update Date | 2012-02-15 |