| NPI | 1174919799 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA A193768) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NV 21216) |
| Enumeration Date | 2015-04-10 |
| Last Update Date | 2024-02-28 |