| NPI | 1306227814 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA A172757) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MA L-263337) |
| Enumeration Date | 2015-06-11 |
| Last Update Date | 2021-09-09 |