| NPI | 1639370257 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TN 34477) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MS 18808) |
| Enumeration Date | 2007-05-30 |
| Last Update Date | 2011-06-03 |