| NPI | 1356757512 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL OS13535) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA 20A17143) |
| Enumeration Date | 2014-07-09 |
| Last Update Date | 2021-04-08 |