| NPI | 1578575734 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WA MD00047792) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WA ML20007417) |
| Enumeration Date | 2006-08-13 |
| Last Update Date | 2022-10-24 |