| NPI | 1144261397 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WA OP00001603) |
| Additional Taxonomies | 204C00000X Neuromusculoskeletal Medicine, Sports Medicine (Licence: WA 025207op00001603) |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2011-06-23 |