| NPI | 1851387351 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: TN 19879) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TN MD0000019879) |
| Enumeration Date | 2005-09-21 |
| Last Update Date | 2021-01-20 |