| NPI | 1578058392 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA 20A17789) |
| Additional Taxonomies | 207XX0004X Orthopaedic Surgery Foot and Ankle Surgery (Licence: CA 20A17789) |
| Enumeration Date | 2018-06-25 |
| Last Update Date | 2024-11-18 |