| NPI | 1043418452 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA A89805) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX M8678) |
| Enumeration Date | 2007-07-06 |
| Last Update Date | 2021-09-30 |