| NPI | 1124278668 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: CA A106986) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OH 35095075) |
| Enumeration Date | 2008-09-20 |
| Last Update Date | 2011-03-18 |