NPI | 1780181107 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: CA A201416) |
Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: AZ 74981) |
Enumeration Date | 2018-04-11 |
Last Update Date | 2025-08-26 |