| NPI | 1922098805 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: OH 35-08-5488) |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: IN 01064440A) |
| Enumeration Date | 2005-10-24 |
| Last Update Date | 2014-07-16 |