| NPI | 1568023737 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA A191935) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MT219422) |
| Enumeration Date | 2019-06-27 |
| Last Update Date | 2024-08-05 |