| NPI | 1962666560 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA MD444669) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA A120652) |
| Enumeration Date | 2008-07-12 |
| Last Update Date | 2013-08-02 |