| NPI | 1235345745 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA A90405) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: ID M-12852) |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2025-07-24 |