| NPI | 1386794113 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: GA 63576) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 200301449) |
| 207X00000X Orthopaedic Surgery (Licence: VA 0101245422) | |
| Enumeration Date | 2007-01-12 |
| Last Update Date | 2023-03-07 |