| NPI | 1508278243 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: SC LL36875) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TN 59033) |
| Enumeration Date | 2014-05-29 |
| Last Update Date | 2020-08-20 |