| NPI | 1639327364 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WA MD60249500) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA A102201) |
| 207X00000X Orthopaedic Surgery (Licence: WA MD60248500) | |
| Enumeration Date | 2008-09-06 |
| Last Update Date | 2021-04-15 |