| NPI | 1972697704 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA G59493) |
| Additional Taxonomies | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: CA G59493) |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: CA G59493) | |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: CA G59493) | |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2015-08-31 |