| NPI | 1992065940 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: AL 41631) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA 154567) |
| Enumeration Date | 2012-05-24 |
| Last Update Date | 2024-03-12 |