| NPI | 1003046095 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CO 55621) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA A130217) |
| Enumeration Date | 2009-07-23 |
| Last Update Date | 2022-01-27 |