| NPI | 1346215209 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery Sports Medicine (Licence: TN 31462) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TN 31462) |
| Enumeration Date | 2006-02-22 |
| Last Update Date | 2021-04-02 |