| NPI | 1407203755 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: TN 4596) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: VA 0102206422) |
| Enumeration Date | 2016-05-17 |
| Last Update Date | 2023-10-30 |