| NPI | 1821230798 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NY 266262) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA A116971) |
| 207X00000X Orthopaedic Surgery (Licence: MA 237518) | |
| Enumeration Date | 2009-03-24 |
| Last Update Date | 2016-03-11 |