| NPI | 1932593548 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MS 27163) |
| Additional Taxonomies | 282N00000X General Acute Care Hospital |
| Enumeration Date | 2015-03-20 |
| Last Update Date | 2022-11-15 |