| NPI | 1497753636 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WA MD00012944) |
| Additional Taxonomies | 174400000X Specialist (Licence: WA MD00012944) |
| Enumeration Date | 2005-07-12 |
| Last Update Date | 2021-01-18 |