| NPI | 1396771192 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CO 36890) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA A100633) |
| Enumeration Date | 2006-06-23 |
| Last Update Date | 2015-07-23 |