| NPI | 1043418759 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: CA a126807) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MT190910) |
| Enumeration Date | 2007-07-03 |
| Last Update Date | 2018-03-29 |