| NPI | 1578547915 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX N1108) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: IN 01060660A) |
| 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: TX N1108) | |
| Enumeration Date | 2005-11-30 |
| Last Update Date | 2019-06-03 |