| NPI | 1942563341 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: AZ R80555) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA C171415) |
| Enumeration Date | 2012-06-20 |
| Last Update Date | 2023-07-21 |