| NPI | 1992847743 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA G54799)  | 
| Additional Taxonomies | 208600000X Surgery (Licence: CA G54799)  | 
| Enumeration Date | 2007-02-12 | 
| Last Update Date | 2014-08-06 |