| NPI | 1255594818 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA A110648) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY 258964) |
| Enumeration Date | 2008-07-03 |
| Last Update Date | 2018-02-19 |