| NPI | 1023197159 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery Sports Medicine (Licence: HI MD-11324) |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery Sports Medicine (Licence: CA A78934) |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2021-06-30 |