| NPI | 1568812774 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA A172070) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MO 2016016969) |
| Enumeration Date | 2016-06-18 |
| Last Update Date | 2022-05-27 |