| NPI | 1932248499 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: WA MD00022672) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WA 207XX0004X) |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2011-09-26 |