| NPI | 1407485311 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: PA MD495745) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA A201632) |
| Enumeration Date | 2020-04-02 |
| Last Update Date | 2026-08-27 |