| NPI | 1568805141 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: GA 83160) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA A153607) |
| 207X00000X Orthopaedic Surgery (Licence: SC 82336) | |
| Enumeration Date | 2013-04-12 |
| Last Update Date | 2019-10-29 |