| NPI | 1467815332 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: GA 91149) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NC 2021-01081) |
| Enumeration Date | 2016-03-30 |
| Last Update Date | 2022-10-11 |