| NPI | 1972961761 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NE 1717) |
| Additional Taxonomies | 208D00000X General Practice (Licence: WA OL60707461) |
| Enumeration Date | 2016-02-08 |
| Last Update Date | 2024-06-17 |