| NPI | 1740864313 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA 20A24941) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI 5151015096) |
| Enumeration Date | 2021-05-10 |
| Last Update Date | 2026-08-13 |