| NPI | 1528226644 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: GA 89234) |
| Additional Taxonomies | 163WW0000X Registered Nurse Wound Care (Licence: GA 89234) |
| Enumeration Date | 2008-05-27 |
| Last Update Date | 2022-03-14 |