| NPI | 1164403549 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NV 4786) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA G51856) |
| 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: NV 4786) | |
| Enumeration Date | 2005-11-11 |
| Last Update Date | 2016-06-10 |