| NPI | 1023463726 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: ME MD21410) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA 142001) |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: CA 142001) | |
| Enumeration Date | 2016-04-30 |
| Last Update Date | 2022-07-21 |