| NPI | 1699917492 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA A137540) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NE 28465) |
| Enumeration Date | 2009-03-25 |
| Last Update Date | 2024-01-08 |