| NPI | 1316932601 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: ID M6029) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WA WA0029535) |
| Enumeration Date | 2005-09-13 |
| Last Update Date | 2024-07-19 |