| NPI | 1801109640 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: TN 4080) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: KY 03837) |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: KY 03837) | |
| Enumeration Date | 2010-07-21 |
| Last Update Date | 2020-10-16 |