| NPI | 1083907125 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0801X Orthopaedic Surgery Orthopaedic Trauma (Licence: SC 40614) |
| Additional Taxonomies | 207XX0801X Orthopaedic Surgery Orthopaedic Trauma (Licence: WA MD60636860) |
| Enumeration Date | 2011-05-23 |
| Last Update Date | 2018-03-09 |