| NPI | 1831374347 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: WA OP60224828) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WA OP60224828) |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: WA OP60224828) | |
| 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: WA OP60224828) | |
| 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: WA OP60224828) | |
| Enumeration Date | 2008-01-02 |
| Last Update Date | 2012-02-15 |