| NPI | 1174639488 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: CO DR.0042487) |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: CA A70301) |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2019-09-06 |