| NPI | 1306246012 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TN 61292) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MD467871) |
| Enumeration Date | 2014-08-29 |
| Last Update Date | 2022-03-16 |