| NPI | 1114183472 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA A125781) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WA MD60261133) |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: CA A125781) | |
| Enumeration Date | 2008-08-05 |
| Last Update Date | 2020-05-11 |