| NPI | 1124106133 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MS 23185) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: GA 64863) |
| 207X00000X Orthopaedic Surgery (Licence: TN MD0000045338) | |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2017-07-10 |