| NPI | 1053773507 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MT 112891) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TN 62849) |
| 207X00000X Orthopaedic Surgery (Licence: MI 4301110371) | |
| Enumeration Date | 2016-03-23 |
| Last Update Date | 2022-08-31 |