| NPI | 1366763138 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: CA A144787) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI 4301096227) |
| Enumeration Date | 2010-06-16 |
| Last Update Date | 2017-12-14 |