| NPI | 1053450072 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA C149911) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NV 17241) |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2018-08-30 |