| NPI | 1508910944 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: AZ 40472) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA A98632) |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2016-05-09 |