| NPI | 1629128160 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: CA g43416) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA G43416) |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2021-11-12 |