| NPI | 1780859850 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NH 20992) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA A101376) |
| 207X00000X Orthopaedic Surgery (Licence: MI 4301091173) | |
| Enumeration Date | 2008-04-29 |
| Last Update Date | 2020-11-17 |