| NPI | 1740215276 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery Sports Medicine (Licence: NH 12684) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NH 12684) |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2019-02-08 |