| NPI | 1760426837 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0004X Orthopaedic Surgery Foot and Ankle Surgery (Licence: CA C37519) |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery Sports Medicine (Licence: CA C37519) |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2020-02-17 |