| NPI | 1912448325 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: CA A157054) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TN 65121) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-03-17 |
| Last Update Date | 2023-10-27 |