| NPI | 1720119852 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA A93459) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA A93459) |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2011-07-07 |