| NPI | 1538302963 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: GA 73924) |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: CA A129340) |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: GA 73924) | |
| Enumeration Date | 2009-04-15 |
| Last Update Date | 2022-01-10 |