| NPI | 1174590780 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TN MD33869) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: GA 80785) |
| Enumeration Date | 2006-03-02 |
| Last Update Date | 2024-04-04 |