| NPI | 1497071617 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WA MD60658823) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA 207X00000X) |
| Enumeration Date | 2010-04-13 |
| Last Update Date | 2021-04-29 |