| NPI | 1114058997 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: SC 36202) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA A115408) |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2014-02-11 |