| NPI | 1609874726 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: GA 058902) | 
| Additional Taxonomies | 174400000X Specialist (Licence: IN 01057724A) | 
| Enumeration Date | 2005-07-12 | 
| Last Update Date | 2021-09-02 |