| NPI | 1184189821 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant (Licence: 21-207) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL OS17355) |
| Enumeration Date | 2019-02-06 |
| Last Update Date | 2023-02-18 |