| NPI | 1144583428 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery Sports Medicine (Licence: CA A147016) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: AK 170213) |
| 207XX0005X Orthopaedic Surgery Sports Medicine (Licence: AK 170213) | |
| Enumeration Date | 2012-06-21 |
| Last Update Date | 2021-04-27 |