| NPI | 1568411338 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: GA 066351) | 
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WI 48724) | 
| 207X00000X Orthopaedic Surgery (Licence: GA 066351) | |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: AL MD.29445) | |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: IN 01067922A) | |
| Enumeration Date | 2006-05-09 | 
| Last Update Date | 2023-01-24 |