| NPI | 1215386594 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TN 63374) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI 4301110288) |
| Enumeration Date | 2016-06-08 |
| Last Update Date | 2022-03-30 |