| NPI | 1598093304 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA A108153) |
| Additional Taxonomies | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: WA MD60332739) |
| Enumeration Date | 2009-12-07 |
| Last Update Date | 2020-03-26 |