| NPI | 1114126158 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA G88013) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: ND 10692) |
| Enumeration Date | 2007-07-11 |
| Last Update Date | 2007-12-26 |