| NPI | 1073877924 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: GA 079849) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MS 24995) |
| 207X00000X Orthopaedic Surgery (Licence: TN 55670) | |
| Enumeration Date | 2012-06-26 |
| Last Update Date | 2023-01-24 |