| NPI | 1629310743 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: CA A172139) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA A172139) |
| Enumeration Date | 2013-03-27 |
| Last Update Date | 2025-10-21 |