| NPI | 1083876833 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MS T2116) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA A123919) |
| Enumeration Date | 2008-07-01 |
| Last Update Date | 2014-10-17 |