| NPI | 1588041669 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: CA 20A18879) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI 5101021550) |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: NV DO2665) | |
| Enumeration Date | 2015-04-28 |
| Last Update Date | 2021-08-19 |