| NPI | 1760882781 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA A171535) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WA MD61048520) |
| Enumeration Date | 2014-08-27 |
| Last Update Date | 2023-01-13 |