| NPI | 1235458183 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: TN 2908) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TN 2908) |
| 207X00000X Orthopaedic Surgery (Licence: VA 0102203670) | |
| 207X00000X Orthopaedic Surgery (Licence: OH 58.003128) | |
| Enumeration Date | 2010-05-18 |
| Last Update Date | 2020-06-08 |