| NPI | 1124134952 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: AR E7016) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TN 47186) |
| 207X00000X Orthopaedic Surgery (Licence: MS 21992) | |
| Enumeration Date | 2006-08-22 |
| Last Update Date | 2023-04-06 |