| NPI | 1154681708 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA A156466) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MT201562) |
| Enumeration Date | 2012-05-16 |
| Last Update Date | 2018-10-16 |