| NPI | 1144439316 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA 20A10721) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY 248035) |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2012-05-02 |