| NPI | 1790048007 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA A146875) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MO 2012017469) |
| Enumeration Date | 2012-06-21 |
| Last Update Date | 2022-07-21 |