| NPI | 1205120177 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: CO DR.0063541) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MO 2016032298) |
| 207X00000X Orthopaedic Surgery (Licence: KY 49721) | |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: TN 54531) | |
| 208D00000X General Practice (Licence: HI MD-16545) | |
| Enumeration Date | 2011-06-07 |
| Last Update Date | 2021-10-25 |