| NPI | 1982690095 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: LA 10265R) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: HI MD7157) |
| Enumeration Date | 2005-09-23 |
| Last Update Date | 2020-08-31 |