| NPI | 1376577411 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA A78753) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA A787530) |
| 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: CA A78753) | |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2010-05-21 |