| NPI | 1427077064 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: OK 31746) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA A96277) |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: NH 18515) | |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2022-10-11 |