| NPI | 1871172494 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME179321) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA A197050) |
| Enumeration Date | 2021-04-02 |
| Last Update Date | 2026-03-03 |