| NPI | 1740805365 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA A201177) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI 4301508914) |
| Enumeration Date | 2020-06-09 |
| Last Update Date | 2025-06-24 |