| NPI | 1316513419 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TN 77372) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MA 288793) |
| Enumeration Date | 2021-05-28 |
| Last Update Date | 2026-08-10 |