| NPI | 1386941219 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA A126049) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY 265850-1) |
| Enumeration Date | 2011-02-10 |
| Last Update Date | 2013-10-07 |