| NPI | 1114555729 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA A203811) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI 4301517818) |
| Enumeration Date | 2020-03-30 |
| Last Update Date | 2026-06-24 |