| NPI | 1790211696 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA A158146) |
| Additional Taxonomies | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: CA A158146) |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: CA A158146) | |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2024-06-07 |