| NPI | 1942296058 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA GFE72814) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: VA 0101232591) |
| Enumeration Date | 2005-09-23 |
| Last Update Date | 2021-12-02 |