| NPI | 1336151455 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA A78619) |
| Additional Taxonomies | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: CA A78619) |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: CA A78619) | |
| Enumeration Date | 2006-08-13 |
| Last Update Date | 2024-11-11 |