| NPI | 1275028938 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA MD491788) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA A194996) |
| 207X00000X Orthopaedic Surgery (Licence: MI 4301115438) | |
| Enumeration Date | 2018-06-26 |
| Last Update Date | 2025-09-15 |