| NPI | 1144365529 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA A73534) | 
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WA MD00045455) | 
| Enumeration Date | 2007-02-21 | 
| Last Update Date | 2019-09-18 |