| NPI | 1477964146 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WA MD61083660) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA A143228) |
| Enumeration Date | 2014-05-15 |
| Last Update Date | 2020-09-11 |