| NPI | 1831196583 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XS0106X Orthopaedic Surgery, Hand Surgery (Licence: WA MD00041304) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WA MD00041304) |
| 207X00000X Orthopaedic Surgery (Licence: WA 41304) | |
| Enumeration Date | 2005-07-07 |
| Last Update Date | 2024-03-15 |