| NPI | 1326879131 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA SPI901) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MN 34071) |
| Enumeration Date | 2024-08-13 |
| Last Update Date | 2025-11-06 |