| NPI | 1780909002 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA A153734) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NE 26624) |
| Enumeration Date | 2010-03-30 |
| Last Update Date | 2025-01-03 |