| NPI | 1699761387 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MS 15741) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TN 34061) |
| Enumeration Date | 2005-09-27 |
| Last Update Date | 2018-05-01 |