| NPI | 1891774097 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NH 22289) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MA 80001) |
| Enumeration Date | 2006-01-16 |
| Last Update Date | 2022-01-24 |