| NPI | 1740293216 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: VA 0101266016) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA A92235) |
| 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: CA A92235) | |
| 207X00000X Orthopaedic Surgery (Licence: VA 0101266016) | |
| Enumeration Date | 2006-08-14 |
| Last Update Date | 2023-03-06 |