| NPI | 1013131705 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA A105407) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MA 221683) |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2022-09-07 |