| NPI | 1538269006 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WA MD60137857) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WA ML20008136) |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: WA MD60137857) | |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2012-12-31 |