| NPI | 1104440049 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: KY 62206) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: IN 01099839A) |
| 207X00000X Orthopaedic Surgery (Licence: TX V7233) | |
| 207X00000X Orthopaedic Surgery (Licence: IL 125.076082) | |
| Enumeration Date | 2020-06-06 |
| Last Update Date | 2026-06-30 |