| NPI | 1902062227 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery Sports Medicine (Licence: IA 38490) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA A108055) |
| 207X00000X Orthopaedic Surgery (Licence: IA 38490) | |
| 207X00000X Orthopaedic Surgery (Licence: IL 036-123886) | |
| Enumeration Date | 2008-08-06 |
| Last Update Date | 2017-02-01 |