| NPI | 1588691174 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: CA G80755) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA G80755) |
| Enumeration Date | 2006-06-27 |
| Last Update Date | 2015-02-25 |