| NPI | 1184936973 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA 20A14723) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI 5101018883) |
| 207X00000X Orthopaedic Surgery (Licence: VA 0102203963) | |
| Enumeration Date | 2010-07-08 |
| Last Update Date | 2016-09-02 |