| NPI | 1215258447 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: CA A118724) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA A118724) |
| Enumeration Date | 2010-06-22 |
| Last Update Date | 2014-11-18 |