| NPI | 1295822930 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WA 00023310) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NC 95-00304) |
| Enumeration Date | 2006-10-06 |
| Last Update Date | 2016-01-14 |