| NPI | 1386957785 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA A121228) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NC 2015-00873) |
| Enumeration Date | 2010-07-15 |
| Last Update Date | 2018-05-22 |