| NPI | 1255472718 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA G52441) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MO 2009014175) |
| Enumeration Date | 2007-02-09 |
| Last Update Date | 2022-06-14 |