| NPI | 1023456720 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TN 58351) |
| Additional Taxonomies | 208600000X Surgery (Licence: SC LL35780) |
| 207X00000X Orthopaedic Surgery (Licence: MS T-2796) | |
| Enumeration Date | 2013-06-05 |
| Last Update Date | 2019-07-08 |