| NPI | 1023577988 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MA 1018425) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA A182442) |
| 207X00000X Orthopaedic Surgery (Licence: NY 338327) | |
| Enumeration Date | 2019-03-19 |
| Last Update Date | 2026-02-13 |