| NPI | 1659555258 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: SC 32139) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA A91645) |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: SC 32139) | |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: CA A91645) | |
| Enumeration Date | 2007-12-19 |
| Last Update Date | 2022-02-21 |