| NPI | 1255393492 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA G51596) |
| Additional Taxonomies | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: CA G51596) |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: CA G51596) | |
| 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: CA G51596) | |
| Enumeration Date | 2006-04-04 |
| Last Update Date | 2010-03-02 |