| NPI | 1114332327 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: WA 61154921) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA A167460) |
| 207X00000X Orthopaedic Surgery (Licence: PA MT206268) | |
| 207X00000X Orthopaedic Surgery (Licence: WA MD61154921) | |
| Enumeration Date | 2014-06-25 |
| Last Update Date | 2021-07-29 |