| NPI | 1730150830 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA A61920) |
| Additional Taxonomies | 204C00000X Neuromusculoskeletal Medicine, Sports Medicine (Licence: CA 61920) |
| 207XX0005X Orthopaedic Surgery Sports Medicine (Licence: CA A61920) | |
| Enumeration Date | 2006-01-28 |
| Last Update Date | 2023-01-09 |