| NPI | 1770873267 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WA MD60744480) |
| Additional Taxonomies | 207XS0106X Orthopaedic Surgery, Hand Surgery (Licence: WA MD60744480) |
| Enumeration Date | 2011-04-18 |
| Last Update Date | 2023-10-05 |