| NPI | 1780689406 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA A054508) |
| Additional Taxonomies | 174400000X Specialist (Licence: FL ME84652) |
| Enumeration Date | 2005-06-17 |
| Last Update Date | 2023-06-27 |