| NPI | 1376618959 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OR 13333) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA G33953) |
| Enumeration Date | 2006-11-21 |
| Last Update Date | 2007-07-08 |