| NPI | 1396804779 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: GA 90646) |
| Additional Taxonomies | 208D00000X General Practice (Licence: NE 1349) |
| Enumeration Date | 2006-12-08 |
| Last Update Date | 2022-07-25 |