| NPI | 1962465039 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: KY 24400) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: IN 01074485A) |
| Enumeration Date | 2006-04-10 |
| Last Update Date | 2021-05-14 |