| NPI | 1730380833 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WA MD6001706) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA A99795) |
| Enumeration Date | 2007-05-29 |
| Last Update Date | 2011-03-02 |