| NPI | 1902913676 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: IA 37415) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA A96507) |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: IA 37415) | |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2009-12-29 |