| NPI | 1093797367 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: CA C54254) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: VA 0101102750) |
| 207X00000X Orthopaedic Surgery (Licence: GA 57605) | |
| 207X00000X Orthopaedic Surgery (Licence: CA C54254) | |
| Enumeration Date | 2005-11-14 |
| Last Update Date | 2026-03-25 |