| NPI | 1477546885 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TN 27446) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: GA 034145) |
| 207X00000X Orthopaedic Surgery (Licence: VA 0101271210) | |
| Enumeration Date | 2005-08-31 |
| Last Update Date | 2020-12-11 |