| NPI | 1528053790 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: ID M7862) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WA MD00037759) |
| Enumeration Date | 2005-09-14 |
| Last Update Date | 2016-06-24 |