| NPI | 1699769059 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TN 28151) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: GA 042470) |
| Enumeration Date | 2005-08-31 |
| Last Update Date | 2024-05-15 |