| NPI | 1457302887 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NV 6391) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA G71822) |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: CA G71822) | |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: NV 6391) | |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2011-06-09 |