| NPI | 1417392689 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA A133993) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MN 65735) |
| 207X00000X Orthopaedic Surgery (Licence: CA 1417393689) | |
| Enumeration Date | 2013-05-01 |
| Last Update Date | 2020-10-09 |