| NPI | 1043674856 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CO DR.0069656) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA 18963) |
| Enumeration Date | 2016-04-07 |
| Last Update Date | 2022-10-27 |