| NPI | 1447041512 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: CA A209347) |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: WA MD61667996) |
| 207X00000X Orthopaedic Surgery (Licence: WA MD61667996) | |
| 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: WA MD61667996) | |
| Enumeration Date | 2025-05-16 |
| Last Update Date | 2026-05-25 |