| NPI | 1750731998 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: VA 0101281204) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TN 62780) |
| 207X00000X Orthopaedic Surgery (Licence: SC 39629) | |
| Enumeration Date | 2016-06-19 |
| Last Update Date | 2025-10-22 |