| NPI | 1063861102 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WA OP61282583) |
| Additional Taxonomies | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: WA OP61282583) |
| Enumeration Date | 2016-06-09 |
| Last Update Date | 2022-07-27 |