| NPI | 1790003499 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: AR E-7598) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NC 2015-00181) |
| Enumeration Date | 2010-05-06 |
| Last Update Date | 2021-10-06 |