| NPI | 1598031304 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA A128858) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NC 2017-00172) |
| Enumeration Date | 2012-03-26 |
| Last Update Date | 2021-12-06 |