| NPI | 1255794889 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NY 314663) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA A180372) |
| Enumeration Date | 2016-03-31 |
| Last Update Date | 2023-06-09 |