| NPI | 1578502407 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MS 19772) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA A96104) |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2011-11-17 |