| NPI | 1396907705 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TN 54782) |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: FL ME 123920) |
| 207X00000X Orthopaedic Surgery (Licence: OH 35.129501) | |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: TN 54782) | |
| Enumeration Date | 2008-06-26 |
| Last Update Date | 2017-03-21 |