| NPI | 1134377765 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA a117048) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA md441970) |
| Enumeration Date | 2008-09-08 |
| Last Update Date | 2021-11-06 |