| NPI | 1396162673 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: OR MD206048) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WA MD60932486) |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: WA MD60932486) | |
| Enumeration Date | 2014-03-24 |
| Last Update Date | 2021-10-24 |