| NPI | 1033597687 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA A171846) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: RI MD17091) |
| Enumeration Date | 2015-05-15 |
| Last Update Date | 2022-12-07 |