NPI | 1982903142 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WA MD60476167) |
Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: WA MD60476167) |
Enumeration Date | 2011-03-26 |
Last Update Date | 2024-05-23 |