| NPI | 1538784814 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TN 73857) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: SC 84479) |
| Enumeration Date | 2020-06-11 |
| Last Update Date | 2025-07-31 |