| NPI | 1982800215 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OR MD188826) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA A148512) |
| 207X00000X Orthopaedic Surgery (Licence: NY 267612) | |
| Enumeration Date | 2007-06-24 |
| Last Update Date | 2020-12-08 |