| NPI | 1255322640 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NV 6420) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA G54590) |
| Enumeration Date | 2005-11-03 |
| Last Update Date | 2021-07-20 |