| NPI | 1639554330 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WA 61177297) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA A146995) |
| Enumeration Date | 2015-07-23 |
| Last Update Date | 2021-09-09 |