| NPI | 1326363557 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA 143495) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WA ML60163928) |
| 207X00000X Orthopaedic Surgery (Licence: MI 4301106545) | |
| Enumeration Date | 2010-03-31 |
| Last Update Date | 2020-02-18 |