| NPI | 1033485404 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: TN MD0000063618) |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: NE 31386) |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: IA MD-45407) | |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: FL ME149074) | |
| Enumeration Date | 2012-03-29 |
| Last Update Date | 2024-02-08 |