| NPI | 1811028012 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA G046100) |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: CA G046100) |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: CA G046100) | |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2012-02-17 |