| NPI | 1891969184 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA A130401) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MN 107051) |
| 207X00000X Orthopaedic Surgery (Licence: MN 56898) | |
| 207X00000X Orthopaedic Surgery (Licence: OH 35129198) | |
| Enumeration Date | 2008-04-17 |
| Last Update Date | 2020-11-30 |