| NPI | 1629042031 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA C55345) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WA MD00048857) |
| Enumeration Date | 2006-02-14 |
| Last Update Date | 2017-04-19 |