| NPI | 1649386137 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: SC 30115) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA A95778) |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2020-10-22 |