| NPI | 1669738290 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: HI MD-22036) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: CA A126858) | |
| Enumeration Date | 2012-04-09 |
| Last Update Date | 2025-11-10 |