| NPI | 1285888354 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: UT 7152083-1205) |
| Additional Taxonomies | 207XX0801X Orthopaedic Surgery Orthopaedic Trauma (Licence: CA A121194) |
| Enumeration Date | 2008-11-15 |
| Last Update Date | 2021-11-17 |