| NPI | 1700023561 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MD D89644) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA A94694) |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: DC MD038605) | |
| Enumeration Date | 2009-01-15 |
| Last Update Date | 2022-10-25 |