| NPI | 1407825292 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WA MD00044866) |
| Additional Taxonomies | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: WA MD00044866) |
| Enumeration Date | 2006-03-15 |
| Last Update Date | 2020-01-23 |