| NPI | 1790051084 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: OR MD188610) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA A148264) |
| Enumeration Date | 2012-03-30 |
| Last Update Date | 2018-08-30 |