| NPI | 1184144115 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TN 68400) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CO DR.0067769) |
| 207X00000X Orthopaedic Surgery (Licence: MO 2017020684) | |
| Enumeration Date | 2017-06-21 |
| Last Update Date | 2023-09-15 |