| NPI | 1174685333 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA 00G437130) |
| Additional Taxonomies | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: CA 00G437130) |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: CA 00G437130) | |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: CA 00G437130) | |
| Enumeration Date | 2006-12-14 |
| Last Update Date | 2014-01-06 |