| NPI | 1801153622 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery Sports Medicine (Licence: TN 57772) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TN 57772) |
| Enumeration Date | 2012-04-18 |
| Last Update Date | 2024-02-28 |