| NPI | 1013414432 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MI 4301514816) |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: CA A196123) |
| Enumeration Date | 2018-04-11 |
| Last Update Date | 2025-11-04 |