| NPI | 1972097939 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: CA A184818) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MO 2018017103) |
| 207X00000X Orthopaedic Surgery (Licence: CA A184818) | |
| Enumeration Date | 2018-06-21 |
| Last Update Date | 2025-12-02 |