| NPI | 1770745432 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: TN 51591) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TN MD51591) |
| Enumeration Date | 2008-06-25 |
| Last Update Date | 2022-03-29 |