| NPI | 1861509689 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA G53095) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA G530950) |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2016-08-15 |