| NPI | 1649628371 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TN 6212) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: VA 0102206435) |
| Enumeration Date | 2016-06-03 |
| Last Update Date | 2025-08-22 |