| NPI | 1467011775 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: VA 0101275953) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: VA 0101275953) |
| Enumeration Date | 2019-06-10 |
| Last Update Date | 2025-08-04 |