| NPI | 1487629671 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA A95445) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MN 47437) |
| Enumeration Date | 2006-02-21 |
| Last Update Date | 2017-07-03 |