| NPI | 1598391419 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA A202315) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL ME180211) |
| 207X00000X Orthopaedic Surgery (Licence: GA 113613) | |
| Enumeration Date | 2020-03-23 |
| Last Update Date | 2026-07-07 |