| NPI | 1952351975 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA G28724) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NV 13805) |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2014-07-16 |