| NPI | 1407411655 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: VA 0101275949) |
| Additional Taxonomies | 208D00000X General Practice (Licence: VA 0101275949) |
| Enumeration Date | 2019-05-02 |
| Last Update Date | 2026-07-17 |