| NPI | 1699070508 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery Adult Reconstructive Orthopaedic Surgery (Licence: CA F5645) |
| Additional Taxonomies | 207XX0801X Orthopaedic Surgery Orthopaedic Trauma (Licence: CA F5645) |
| Enumeration Date | 2011-01-24 |
| Last Update Date | 2013-02-21 |