| NPI | 1619037496 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: CA A90915) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA A90915) |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2024-04-27 |