| NPI | 1366434078 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: TN MD30479) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: AL 17684) |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: AL 17684) | |
| Enumeration Date | 2005-08-18 |
| Last Update Date | 2016-06-02 |