| NPI | 1679676530 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA G51976) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WY 4517A) |
| 207X00000X Orthopaedic Surgery (Licence: ID M5857) | |
| 207X00000X Orthopaedic Surgery (Licence: MT 7727) | |
| Enumeration Date | 2006-09-06 |
| Last Update Date | 2024-09-08 |