| NPI | 1861409245 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery Sports Medicine (Licence: TN MD38676) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TN MD38676) |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2015-11-02 |