| NPI | 1811133101 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: GA 082109) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: VA 0101256205) |
| Enumeration Date | 2008-12-17 |
| Last Update Date | 2021-12-07 |