| NPI | 1073976502 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TN 65315) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: GA 008704) |
| 207X00000X Orthopaedic Surgery (Licence: WI 76239) | |
| 207X00000X Orthopaedic Surgery (Licence: MN 68800) | |
| Enumeration Date | 2016-04-01 |
| Last Update Date | 2022-10-13 |