| NPI | 1447423934 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WA MD60463420) |
| Additional Taxonomies | 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: MO 2013006690) |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: WA MD60463420) | |
| Enumeration Date | 2008-04-07 |
| Last Update Date | 2021-06-18 |