| NPI | 1881636009 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0106X Orthopaedic Surgery, Hand Surgery (Licence: WA MD00020017) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WA MD00020017) |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2019-04-02 |