| NPI | 1548392236 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: FL ACN294) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PR 16,737) |
| Enumeration Date | 2007-03-09 |
| Last Update Date | 2013-03-01 |