| NPI | 1861685463 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MO 2009009425) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA a90770) |
| Enumeration Date | 2007-08-27 |
| Last Update Date | 2009-09-18 |