| NPI | 1952612442 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: GA 92300) |
| Additional Taxonomies | 208D00000X General Practice (Licence: HI MD-16617) |
| Enumeration Date | 2010-06-29 |
| Last Update Date | 2022-08-03 |