| NPI | 1528036837 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XX0801X Orthopaedic Surgery Orthopaedic Trauma (Licence: CA 20A8500) |
| Additional Taxonomies | 207XS0114X Orthopaedic Surgery Adult Reconstructive Orthopaedic Surgery (Licence: CA 20A8500) |
| 207XX0801X Orthopaedic Surgery Orthopaedic Trauma (Licence: NY 317334) | |
| Enumeration Date | 2006-03-10 |
| Last Update Date | 2022-06-03 |