| NPI | 1154663607 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: HI MD-21151) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MA 278170) |
| 207X00000X Orthopaedic Surgery (Licence: VA 0101257320) | |
| 208D00000X General Practice (Licence: VA 0101257320) | |
| Enumeration Date | 2013-03-22 |
| Last Update Date | 2023-08-16 |