| NPI | 1184071870 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA A157233) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TN 53863) |
| 208D00000X General Practice (Licence: TN 53863) | |
| Enumeration Date | 2016-05-23 |
| Last Update Date | 2023-03-07 |