| NPI | 1659791689 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA A186742) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MD471315) |
| Enumeration Date | 2014-04-17 |
| Last Update Date | 2023-08-16 |