| NPI | 1649275579 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA G45243) |
| Additional Taxonomies | 207XS0106X Orthopaedic Surgery, Hand Surgery (Licence: CA G45253) |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: CA G45253) | |
| Enumeration Date | 2005-06-16 |
| Last Update Date | 2020-02-10 |