| NPI | 1821086281 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TN 026978) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA G73805) |
| Enumeration Date | 2005-10-11 |
| Last Update Date | 2015-05-12 |