| NPI | 1629000815 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA G64619) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MS 16934) |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2022-02-28 |