| NPI | 1720077910 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TN MD16188) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: AL 16490) |
| Enumeration Date | 2005-10-19 |
| Last Update Date | 2018-11-30 |