| NPI | 1679935944 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: CA A151110) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA A151110) |
| Enumeration Date | 2016-03-24 |
| Last Update Date | 2025-01-23 |