| NPI | 1134563331 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA A132594) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MD D0089880) |
| 207X00000X Orthopaedic Surgery (Licence: CO DR.0062384) | |
| Enumeration Date | 2013-04-18 |
| Last Update Date | 2026-03-09 |