| NPI | 1356576946 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA A126985) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: HI MD-23003) |
| Enumeration Date | 2009-05-26 |
| Last Update Date | 2025-04-24 |