| NPI | 1629336805 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX R7430) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA A148497) |
| Enumeration Date | 2012-04-25 |
| Last Update Date | 2018-10-02 |