| NPI | 1851519771 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: IN 02003900A) |
| Additional Taxonomies | 282N00000X General Acute Care Hospital (Licence: MI 5101016950) |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2022-02-15 |