| NPI | 1093944670 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: CA A144222) |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: NY 281024) |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: MN 66359) | |
| Enumeration Date | 2009-07-05 |
| Last Update Date | 2024-06-20 |