| NPI | 1598973992 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: ID M-10703) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: IA R-7107) |
| 207X00000X Orthopaedic Surgery (Licence: CO 48110) | |
| Enumeration Date | 2007-05-18 |
| Last Update Date | 2024-08-12 |