| NPI | 1932542701 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA 187384) | 
| Additional Taxonomies | 2086X0206X Surgery, Surgical Oncology (Licence: CA 187384) | 
| Enumeration Date | 2013-04-11 | 
| Last Update Date | 2024-11-27 |