| NPI | 1780875393 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA A99471) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MO 2012037238) |
| Enumeration Date | 2007-08-08 |
| Last Update Date | 2015-08-19 |