| NPI | 1053602292 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME144970) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA A141965) |
| 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: FL ME144970) | |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: CA A141965) | |
| Enumeration Date | 2011-04-21 |
| Last Update Date | 2023-12-14 |