| NPI | 1730483769 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: CA A118471) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL ME126409) |
| Enumeration Date | 2011-01-05 |
| Last Update Date | 2021-12-21 |