| NPI | 1053871814 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: CA A181502) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: VA 207X00000X) |
| 207X00000X Orthopaedic Surgery (Licence: CA na) | |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: VA 0101284043) | |
| Enumeration Date | 2019-03-20 |
| Last Update Date | 2025-05-14 |