| NPI | 1972503431 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA G71361) |
| Additional Taxonomies | 207XS0106X Orthopaedic Surgery Hand Surgery (Licence: CA G71361) |
| 207XX0005X Orthopaedic Surgery Sports Medicine (Licence: CA G71361) | |
| 207XX0801X Orthopaedic Surgery Orthopaedic Trauma (Licence: CA G71361) | |
| Enumeration Date | 2005-07-27 |
| Last Update Date | 2016-06-01 |