| NPI | 1356516793 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX N2985) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA A103350) |
| 207X00000X Orthopaedic Surgery (Licence: NY 245682-1) | |
| Enumeration Date | 2008-04-27 |
| Last Update Date | 2009-08-03 |