| NPI | 1023295292 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA A105392) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: UT 8315898-1205) |
| Enumeration Date | 2008-01-29 |
| Last Update Date | 2021-12-06 |