| NPI | 1407147176 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: TN 64869) |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: KY 47738) |
| Enumeration Date | 2011-04-28 |
| Last Update Date | 2023-03-27 |