| NPI | 1801425822 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA A183430) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX V6947) |
| Enumeration Date | 2020-04-02 |
| Last Update Date | 2026-09-16 |