| NPI | 1336136647 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OR MD28080) |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: CA A73647) |
| 207X00000X Orthopaedic Surgery (Licence: CA A73647) | |
| Enumeration Date | 2005-10-03 |
| Last Update Date | 2026-03-18 |