| NPI | 1700013398 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX Q8267) | 
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA A136669) | 
| 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: TX q8267) | |
| 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: TX Q8267) | |
| 208600000X Surgery (Licence: IL 125056946) | |
| Enumeration Date | 2009-06-22 | 
| Last Update Date | 2025-06-11 |