| NPI | 1780844563 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: SC 30846) |
| Additional Taxonomies | 208D00000X General Practice (Licence: SC LL30846) |
| 207X00000X Orthopaedic Surgery (Licence: GA 68863) | |
| Enumeration Date | 2008-06-15 |
| Last Update Date | 2014-08-21 |