| NPI | 1417186610 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA A122659) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL TRN20259) |
| 207X00000X Orthopaedic Surgery (Licence: AZ R71748) | |
| Enumeration Date | 2009-07-09 |
| Last Update Date | 2021-11-04 |