| NPI | 1407877830 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WA OP60390976) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI 5101013559) |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2014-11-17 |