| NPI | 1568872018 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA A159493) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NC 201246) |
| Enumeration Date | 2014-05-06 |
| Last Update Date | 2020-11-12 |