| NPI | 1447284682 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA G49444) |
| Additional Taxonomies | 207XS0114X Orthopaedic Surgery Adult Reconstructive Orthopaedic Surgery (Licence: CA G49444) |
| 207XX0005X Orthopaedic Surgery Sports Medicine (Licence: CA G49444) | |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2011-11-01 |