| NPI | 1689089062 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: GA 91887) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TN 60835) |
| Enumeration Date | 2014-06-24 |
| Last Update Date | 2022-07-27 |