| NPI | 1346702040 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX T0212) |
| Additional Taxonomies | 208D00000X General Practice (Licence: TX T0212) |
| Enumeration Date | 2019-04-02 |
| Last Update Date | 2024-07-08 |