| NPI | 1255950564 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: KY 60702) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: IN 01096868A) |
| Enumeration Date | 2020-04-16 |
| Last Update Date | 2026-02-27 |