| NPI | 1578856332 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NH 18200) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MT199262) |
| Enumeration Date | 2011-05-25 |
| Last Update Date | 2022-07-21 |