| NPI | 1558360628 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: NV 8856) |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: CA A67307) |
| Enumeration Date | 2005-07-20 |
| Last Update Date | 2014-07-16 |