| NPI | 1558334490 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WA MD60284372) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA c53136) |
| 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: CA c53136) | |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: CA c53136) | |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: WA MD60284372) | |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: WA MD60284372) | |
| 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: WA MD60284372) | |
| Enumeration Date | 2006-02-10 |
| Last Update Date | 2012-08-06 |