| NPI | 1073805008 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MN 62821) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA 143822) |
| Enumeration Date | 2011-05-10 |
| Last Update Date | 2023-03-06 |