| NPI | 1740256759 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WA MD00034776) |
| Additional Taxonomies | 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: LA 300997) |
| 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: WA MD00034776) | |
| 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: WA MD00034776) | |
| Enumeration Date | 2006-02-28 |
| Last Update Date | 2019-10-14 |