| NPI | 1447679816 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0801X Orthopaedic Surgery Orthopaedic Trauma (Licence: WA MD60772991) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WA MD60772991) |
| 207XX0004X Orthopaedic Surgery Foot and Ankle Surgery (Licence: WA MD60772991) | |
| Enumeration Date | 2014-04-14 |
| Last Update Date | 2024-05-13 |