| NPI | 1629089941 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA G65200) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MN 44255) |
| Enumeration Date | 2006-08-11 |
| Last Update Date | 2019-09-10 |