| NPI | 1093071268 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: TN 57964) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: AL MD.35895) |
| 207X00000X Orthopaedic Surgery (Licence: TN 57964) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-04-02 |
| Last Update Date | 2026-01-14 |