| NPI | 1013179712 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA 20A13389) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI 5101017801) |
| Enumeration Date | 2008-06-25 |
| Last Update Date | 2014-08-22 |