| NPI | 1578666491 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA 0C26646) |
| Additional Taxonomies | 204C00000X Neuromusculoskeletal Medicine, Sports Medicine (Licence: CA 0C26646) |
| Enumeration Date | 2006-09-06 |
| Last Update Date | 2008-11-21 |