| NPI | 1154404812 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WA MD00042297) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OR MD24512) |
| 207X00000X Orthopaedic Surgery (Licence: CA A060835) | |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2022-02-04 |