| NPI | 1942367040 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MO 2007004694) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: KS 0431759) |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: IN 01062401A) | |
| Enumeration Date | 2007-01-02 |
| Last Update Date | 2022-01-21 |