| NPI | 1720491673 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA A176200) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MA 283092) |
| Enumeration Date | 2014-06-09 |
| Last Update Date | 2022-06-30 |