| NPI | 1205973898 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: CA A112639) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NC 2012-01326) |
| 207X00000X Orthopaedic Surgery (Licence: CA A112639) | |
| 207X00000X Orthopaedic Surgery (Licence: MI 4301111477) | |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: MI 4301111477) | |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2024-04-27 |