| NPI | 1356638977 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: MS T-2405) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MS T-2405) |
| Enumeration Date | 2011-07-03 |
| Last Update Date | 2018-08-09 |