| NPI | 1972869782 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MN 61885) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA A126414) |
| 207X00000X Orthopaedic Surgery (Licence: WI 67510-20) | |
| Enumeration Date | 2012-04-05 |
| Last Update Date | 2021-12-17 |