| NPI | 1477714665 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA A133234) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MT193317) |
| Enumeration Date | 2008-06-19 |
| Last Update Date | 2022-03-22 |