| NPI | 1922204635 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: WA MD60872422) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WA MD60872422) |
| Enumeration Date | 2007-06-21 |
| Last Update Date | 2018-08-09 |