| NPI | 1770070336 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL OS17258) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA 20A20596) |
| 207X00000X Orthopaedic Surgery (Licence: FL UO5943) | |
| Enumeration Date | 2018-04-19 |
| Last Update Date | 2025-12-02 |