| NPI | 1326543752 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NY 327035) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MN 65864) |
| 207X00000X Orthopaedic Surgery (Licence: CA A184355) | |
| Enumeration Date | 2018-03-27 |
| Last Update Date | 2025-08-15 |