| NPI | 1972506145 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TN 48703) |
| Additional Taxonomies | 173000000X Legal Medicine (Licence: KY 34059) |
| Enumeration Date | 2005-05-23 |
| Last Update Date | 2023-12-11 |