| NPI | 1881914653 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA A139526) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: RI LP02015) |
| 207X00000X Orthopaedic Surgery (Licence: RI 14919) | |
| Enumeration Date | 2010-06-03 |
| Last Update Date | 2026-09-25 |