| NPI | 1669583191 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA G64552) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA G64552) |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: CA G64552) | |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2017-02-03 |