| NPI | 1225217011 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WA MD60386052) |
| Additional Taxonomies | 207XX0801X Orthopaedic Surgery Orthopaedic Trauma (Licence: WA MD60386052) |
| Enumeration Date | 2007-10-29 |
| Last Update Date | 2014-01-24 |