| NPI | 1013900562 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: AR E-10082) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: IA 35041) |
| 207X00000X Orthopaedic Surgery (Licence: KY 42906) | |
| Enumeration Date | 2005-08-30 |
| Last Update Date | 2016-10-17 |