| NPI | 1831509355 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: CA A167823) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI 4301105181) |
| 207X00000X Orthopaedic Surgery (Licence: MN 65225) | |
| Enumeration Date | 2014-05-06 |
| Last Update Date | 2020-07-17 |