| NPI | 1659788107 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA A160710) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MT206684) |
| Enumeration Date | 2014-07-16 |
| Last Update Date | 2020-08-05 |