| NPI | 1215424452 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: CA A163982) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA A163982) |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: CO DR.0070547) | |
| Enumeration Date | 2018-04-13 |
| Last Update Date | 2024-09-19 |