| NPI | 1720049620 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA G76285) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NV NV7929) |
| Enumeration Date | 2006-03-30 |
| Last Update Date | 2016-05-20 |