| NPI | 1851381131 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA C338090) |
| Additional Taxonomies | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: CA C33809) |
| 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: CA C33809) | |
| 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: CA C33809) | |
| Enumeration Date | 2005-10-26 |
| Last Update Date | 2012-06-08 |