| NPI | 1073842852 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA A113544) |
| Additional Taxonomies | 286500000X Military Hospital |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: CA A113544) | |
| Enumeration Date | 2009-12-08 |
| Last Update Date | 2015-07-18 |