| NPI | 1487663498 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA A22124) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NV 7455) |
| Enumeration Date | 2006-08-07 |
| Last Update Date | 2007-07-08 |