| NPI | 1851532881 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WA MD60479600) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WA ML60096034) |
| Enumeration Date | 2009-03-22 |
| Last Update Date | 2015-08-06 |