| NPI | 1295788651 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: PR 7624) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PR 7624) |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2024-01-29 |