| NPI | 1356621130 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: FL OS15270) |
| Additional Taxonomies | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: GA 78645) |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: PA OT015575) | |
| 208D00000X General Practice (Licence: FL UO2822) | |
| Enumeration Date | 2011-08-24 |
| Last Update Date | 2022-10-19 |