| NPI | 1578710687 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CO 49850) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA A95872) |
| Enumeration Date | 2008-08-20 |
| Last Update Date | 2017-02-14 |