| NPI | 1083109698 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TN 5777) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA 20A20669) |
| 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: CA 20A20669) | |
| Enumeration Date | 2018-06-26 |
| Last Update Date | 2024-08-19 |