| NPI | 1386626562 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA 196960) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WI 28989) |
| Enumeration Date | 2005-11-15 |
| Last Update Date | 2024-10-18 |