| NPI | 1326602616 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA A193464) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX V7049) |
| Enumeration Date | 2019-04-23 |
| Last Update Date | 2025-07-03 |