| NPI | 1124378047 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: HI MD-17041) |
| Additional Taxonomies | 208D00000X General Practice (Licence: HI 17041) |
| Enumeration Date | 2012-09-18 |
| Last Update Date | 2022-05-16 |