| NPI | 1669030458 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA 20A22409) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA OT019181) |
| Enumeration Date | 2019-06-05 |
| Last Update Date | 2025-03-03 |