| NPI | 1821284282 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TN MD0000017904) |
| Additional Taxonomies | 174400000X Specialist (Licence: TN 17904) |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: TN 17904) | |
| Enumeration Date | 2007-09-19 |
| Last Update Date | 2011-08-22 |