| NPI | 1487640033 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: IN 71001830a) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IN 71001830A) |
| Enumeration Date | 2005-09-20 |
| Last Update Date | 2024-04-23 |