| NPI | 1407825318 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: GA 88530) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA A104417) |
| 207X00000X Orthopaedic Surgery (Licence: NC 200301252) | |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2021-07-07 |