| NPI | 1649686809 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL OS21288) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA OT016132) |
| 207XX0801X Orthopaedic Surgery Orthopaedic Trauma (Licence: MO 2020024393) | |
| Enumeration Date | 2014-07-09 |
| Last Update Date | 2024-09-05 |