| NPI | 1184063265 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA A160382) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MT205257) |
| Enumeration Date | 2013-06-21 |
| Last Update Date | 2022-10-17 |