| NPI | 1306992904 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA A96910) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA A96910) |
| Enumeration Date | 2007-01-26 |
| Last Update Date | 2016-01-20 |