| NPI | 1225558638 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA A178177) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI 4301112502) |
| Enumeration Date | 2017-06-27 |
| Last Update Date | 2022-05-03 |