| NPI | 1205332475 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA A197600) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY 321253) |
| Enumeration Date | 2018-04-04 |
| Last Update Date | 2025-06-24 |