| NPI | 1861441198 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: AR E0329) |
| Additional Taxonomies | 207RA0401X Internal Medicine Addiction Medicine (Licence: AR E-0329) |
| 207XX0005X Orthopaedic Surgery Sports Medicine (Licence: AR E0329) | |
| 2081P2900X Physical Medicine & Rehabilitation Pain Medicine (Licence: AR E-0329) | |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2023-11-07 |