| NPI | 1578023081 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TN 6211) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: GA 100142) |
| Enumeration Date | 2019-03-21 |
| Last Update Date | 2025-12-02 |