NPI | 1871559518 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208D00000X General Practice (Licence: GA 49508) |
Additional Taxonomies | 171000000X Military Health Care Provider (Licence: GA 49508) |
207X00000X Orthopaedic Surgery (Licence: TN MD26989) | |
207X00000X Orthopaedic Surgery (Licence: GA 049508) | |
Enumeration Date | 2006-04-21 |
Last Update Date | 2025-09-16 |