| NPI | 1790746923 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: AL 11388) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TN 12645) |
| Enumeration Date | 2006-03-29 |
| Last Update Date | 2019-10-16 |