| NPI | 1881642098 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA C135744) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MO 2001023606) |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2021-12-16 |