| NPI | 1467611988 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA A142617) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MA 237510) |
| Enumeration Date | 2008-06-09 |
| Last Update Date | 2021-11-05 |