| NPI | 1194838300 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME105002) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WA MD00018997) |
| Enumeration Date | 2006-08-15 |
| Last Update Date | 2012-02-20 |