| NPI | 1578613998 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: WA MD00040590) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WA MD00040590) |
| 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: WA MD00040590) | |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: WA MD00040590) | |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: WA MD00040590) | |
| 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: WA MD00040590) | |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2011-12-21 |