| NPI | 1225665151 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WA MD61668082) |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: WA MD61668082) |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: WA MD61668082) | |
| Enumeration Date | 2020-03-23 |
| Last Update Date | 2025-06-05 |