| NPI | 1003699471 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA A188903) |
| Additional Taxonomies | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: CA A188903) |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: CA A188903) | |
| Enumeration Date | 2023-08-17 |
| Last Update Date | 2023-08-17 |