| NPI | 1750363149 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA G130506) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL ME54499) |
| Enumeration Date | 2005-11-19 |
| Last Update Date | 2023-01-02 |