| NPI | 1144875139 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: VA 0101273846) |
| Additional Taxonomies | 207XP3100X Orthopaedic Surgery Pediatric Orthopaedic Surgery (Licence: VA 0101273846) |
| Enumeration Date | 2019-08-06 |
| Last Update Date | 2022-01-24 |