| NPI | 1538697016 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: AZ 36707) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA C51280) |
| Enumeration Date | 2017-05-30 |
| Last Update Date | 2022-07-21 |