| NPI | 1841636917 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA 20A16204) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX BP10046473) |
| Enumeration Date | 2013-05-16 |
| Last Update Date | 2018-09-25 |