| NPI | 1215183850 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: WA TR60019233) |
| Additional Taxonomies | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: WA TR60019233) |
| Enumeration Date | 2008-08-14 |
| Last Update Date | 2009-04-17 |