| NPI | 1508885047 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: AZ 4810) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL OS10024) |
| 174400000X Specialist (Licence: AZ 4810) | |
| 208D00000X General Practice (Licence: AZ 4810) | |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2020-03-09 |