| NPI | 1245201938 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: CA C29184) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA C29184) |
| Enumeration Date | 2006-01-30 |
| Last Update Date | 2021-08-27 |