| NPI | 1952544884 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: VA 0101258148) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL ME118158) |
| 207X00000X Orthopaedic Surgery (Licence: CA A114337) | |
| Enumeration Date | 2009-04-08 |
| Last Update Date | 2023-02-07 |