| NPI | 1316470321 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TN 65479) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MN 64056) |
| Enumeration Date | 2017-04-06 |
| Last Update Date | 2023-05-26 |