| NPI | 1003002890 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CO 47584) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA A92434) |
| Enumeration Date | 2007-09-14 |
| Last Update Date | 2023-11-02 |