| NPI | 1679891535 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: ND 14841) |
| Additional Taxonomies | 174400000X Specialist (Licence: CO 51107) |
| 207XX0005X Orthopaedic Surgery Sports Medicine (Licence: IN 02004269A) | |
| 207X00000X Orthopaedic Surgery (Licence: IN 02004269A) | |
| Enumeration Date | 2010-05-17 |
| Last Update Date | 2024-09-11 |