| NPI | 1801037692 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA A106700) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: AZ 46228) |
| Enumeration Date | 2009-03-09 |
| Last Update Date | 2016-02-04 |