| NPI | 1972794097 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA A116196) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MA L-224513) |
| Enumeration Date | 2007-08-05 |
| Last Update Date | 2025-11-13 |