| NPI | 1023047438 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA G72913) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OH 35070748) |
| Enumeration Date | 2006-06-30 |
| Last Update Date | 2025-12-09 |