| NPI | 1376759811 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NE 24083) |
| Additional Taxonomies | 208D00000X General Practice (Licence: NE 24083) |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2020-12-03 |