| NPI | 1285678300 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: AR E-11525) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WA MD00042957) |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2019-01-18 |