| NPI | 1932660768 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: AZ 77149) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WI 74138-20) |
| 207X00000X Orthopaedic Surgery (Licence: AZ 77149) | |
| 207X00000X Orthopaedic Surgery (Licence: TN 70373) | |
| Enumeration Date | 2019-03-26 |
| Last Update Date | 2025-07-24 |