| NPI | 1396023032 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA 20A15530) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MN 60579) |
| 207X00000X Orthopaedic Surgery (Licence: PA OT014143) | |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: MN 60579) | |
| Enumeration Date | 2011-07-29 |
| Last Update Date | 2018-06-20 |