| NPI | 1760774616 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TN 56124) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TN MD0000056124) |
| 207X00000X Orthopaedic Surgery (Licence: VA 0101259929) | |
| 207X00000X Orthopaedic Surgery (Licence: TX 0040945) | |
| Enumeration Date | 2011-05-11 |
| Last Update Date | 2021-12-02 |