| NPI | 1093056988 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: GA 081265) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: SC 52399) |
| 208D00000X General Practice (Licence: NE 28038) | |
| Enumeration Date | 2013-03-03 |
| Last Update Date | 2019-10-24 |