| NPI | 1023205077 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA A97423) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MA 246386) |
| Enumeration Date | 2007-10-03 |
| Last Update Date | 2024-04-22 |