| NPI | 1790053841 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL MFC1741)  | 
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: IN 01092437A)  | 
| 207X00000X Orthopaedic Surgery (Licence: ZZ 14308)  | |
| Enumeration Date | 2011-12-05 | 
| Last Update Date | 2025-05-06 |