| NPI | 1245493881 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA A103986) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WA MD60097526) |
| Enumeration Date | 2008-07-03 |
| Last Update Date | 2020-11-30 |