| NPI | 1255315222 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA G145660) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MA 160413) |
| Enumeration Date | 2005-12-02 |
| Last Update Date | 2016-11-14 |