| NPI | 1730648650 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WA MD70007497) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA A182321) |
| Enumeration Date | 2019-03-19 |
| Last Update Date | 2025-09-22 |