| NPI | 1558823435 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA A182570) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MA 1018338) |
| 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: CA A182570) | |
| Enumeration Date | 2019-04-01 |
| Last Update Date | 2025-09-03 |