| NPI | 1588982508 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA A112036) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NC 2014-00601) |
| Enumeration Date | 2010-05-14 |
| Last Update Date | 2015-07-14 |