| NPI | 1023636073 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MA 1022339) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA PTL4907) |
| 207X00000X Orthopaedic Surgery (Licence: CA A180896) | |
| Enumeration Date | 2020-07-07 |
| Last Update Date | 2025-05-09 |