| NPI | 1932152667 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA A63718) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NM MD2015-0936) |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2025-03-11 |