| NPI | 1245285394 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA A55621) |
| Additional Taxonomies | 207XS0114X Orthopaedic Surgery Adult Reconstructive Orthopaedic Surgery (Licence: CA A55621) |
| 207XX0004X Orthopaedic Surgery Foot and Ankle Surgery (Licence: CA A55621) | |
| 207XX0005X Orthopaedic Surgery Sports Medicine (Licence: CA A55621) | |
| 207XX0801X Orthopaedic Surgery Orthopaedic Trauma (Licence: CA A55621) | |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2007-10-10 |