| NPI | 1417129339 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WA MD60925710) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: AL 31201) |
| 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: AL 31201) | |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: AL 31201) | |
| Enumeration Date | 2008-03-31 |
| Last Update Date | 2021-01-18 |