| NPI | 1114216421 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: CA C185826) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CO DR.0058676) |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: CO DR.0058676) | |
| 207X00000X Orthopaedic Surgery (Licence: AL MD.35064) | |
| Enumeration Date | 2011-04-07 |
| Last Update Date | 2025-12-09 |