| NPI | 1699739730 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WA MD00020040) |
| Additional Taxonomies | 208600000X Surgery (Licence: WA MD00020040) |
| Enumeration Date | 2006-04-14 |
| Last Update Date | 2015-06-17 |