| NPI | 1730575010 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA MD475236) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA A168279) |
| Enumeration Date | 2015-04-13 |
| Last Update Date | 2021-10-05 |