| NPI | 1356551089 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: ND 11655) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA A95043) |
| 207X00000X Orthopaedic Surgery (Licence: MN 51683) | |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2022-04-06 |