| NPI | 1386636348 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA G60659) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA G60659) |
| Enumeration Date | 2005-08-16 |
| Last Update Date | 2022-01-07 |