| NPI | 1164456471 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WA MD00030372) |
| Additional Taxonomies | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: WA MD00030372) |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: WA MD00030372) | |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2017-03-08 |