| NPI | 1306367354 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA A176364) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI 4301113134) |
| Enumeration Date | 2017-06-29 |
| Last Update Date | 2023-07-19 |