| NPI | 1487033320 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: KY 54381) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TN 64015) |
| Enumeration Date | 2015-05-26 |
| Last Update Date | 2023-11-07 |