| NPI | 1568872745 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA C208920) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX BP10050857) |
| Enumeration Date | 2014-04-28 |
| Last Update Date | 2026-08-18 |