| NPI | 1093994469 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA e1847955) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CA a108059) |
| Enumeration Date | 2007-11-01 |
| Last Update Date | 2013-05-02 |