| NPI | 1780638007 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: TN 46687) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TN 46687) |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2023-12-19 |