| NPI | 1649305509 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: NC 202001597) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: GA 058816) |
| 207X00000X Orthopaedic Surgery (Licence: PA FR0053986) | |
| 207X00000X Orthopaedic Surgery (Licence: PA MD472492) | |
| 208D00000X General Practice (Licence: NC 01597) | |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2024-04-26 |