| NPI | 1104817493 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CO DR.0059193) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA A92566) |
| Enumeration Date | 2005-11-04 |
| Last Update Date | 2021-04-20 |