| NPI | 1376527440 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA A63715) | 
| Additional Taxonomies | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: CA A63715) | 
| Enumeration Date | 2005-12-02 | 
| Last Update Date | 2014-08-08 |