| NPI | 1124120092 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: CA 20A7777) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA 20A7777) |
| 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: CA 20A7777) | |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: CA 20A7777) | |
| Enumeration Date | 2006-09-02 |
| Last Update Date | 2025-09-11 |