| NPI | 1184832578 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: MN 56331) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA A121113) |
| 207X00000X Orthopaedic Surgery (Licence: NV 14322) | |
| Enumeration Date | 2007-05-18 |
| Last Update Date | 2013-09-19 |