| NPI | 1407825599 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WA 1068238) |
| Additional Taxonomies | 174400000X Specialist (Licence: WA MD00028886) |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2024-11-20 |