| NPI | 1740542380 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA A155923) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI 4301100821) |
| Enumeration Date | 2012-06-11 |
| Last Update Date | 2019-02-12 |