| NPI | 1508052333 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: CA A99619) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OR MD154654) |
| Enumeration Date | 2007-09-14 |
| Last Update Date | 2018-04-05 |