| NPI | 1104946086 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA A99207) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NM MD2008-0378) |
| Enumeration Date | 2007-04-02 |
| Last Update Date | 2021-11-29 |