| NPI | 1871646653 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WA MD27795) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OR MD22226) |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2007-07-08 |