| NPI | 1518997378 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: CA C55502) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA C55502) |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: OR MD26733) | |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: NM MD2012-0840) | |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2021-01-29 |