| NPI | 1336182229 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA G31113) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WA MD00018412) |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2018-07-23 |