| NPI | 1225000110 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NV 3550)  | 
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA G31477)  | 
| Enumeration Date | 2006-02-03 | 
| Last Update Date | 2007-07-08 |