| NPI | 1003817693 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME104071) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA A71367) |
| Enumeration Date | 2005-08-03 |
| Last Update Date | 2016-03-14 |