| NPI | 1790786234 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NY 213053-1) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA C51380) |
| 207X00000X Orthopaedic Surgery (Licence: NY 213053) | |
| Enumeration Date | 2005-08-09 |
| Last Update Date | 2023-06-29 |