| NPI | 1528394202 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery Orthopaedic Surgery of the Spine (Licence: CA A114899) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207XX0801X Orthopaedic Surgery Orthopaedic Trauma (Licence: CA A114899) | |
| Enumeration Date | 2009-10-30 |
| Last Update Date | 2015-05-12 |