| NPI | 1699920769 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA A111402) |
| Additional Taxonomies | 208600000X Surgery (Licence: OH 57-015232) |
| Enumeration Date | 2008-11-17 |
| Last Update Date | 2010-05-25 |