| NPI | 1861713679 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: UT 9715459-1205) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA A135595) |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: UT 9715459-1205) | |
| Enumeration Date | 2010-06-15 |
| Last Update Date | 2016-09-02 |