| NPI | 1801024229 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TN 56293) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NC 2015-01743) |
| 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: TN 56293) | |
| Enumeration Date | 2009-06-24 |
| Last Update Date | 2018-08-14 |