| NPI | 1053601591 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TN 55799) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MS 24906) |
| 207X00000X Orthopaedic Surgery (Licence: PA MD457009) | |
| Enumeration Date | 2011-04-18 |
| Last Update Date | 2022-10-05 |