NPI | 1285625384 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: CA A77306) |
Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA A77306) |
Enumeration Date | 2005-10-31 |
Last Update Date | 2022-02-11 |