| NPI | 1023379369 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MO 2025030380) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA C183962) |
| Enumeration Date | 2012-06-04 |
| Last Update Date | 2025-10-09 |