| NPI | 1740504638 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA 142055) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MA 261691) |
| Enumeration Date | 2010-03-21 |
| Last Update Date | 2022-01-04 |