| NPI | 1982917399 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: ND 13113) |
| Additional Taxonomies | 208D00000X General Practice (Licence: MI 01927) |
| Enumeration Date | 2010-07-15 |
| Last Update Date | 2023-12-26 |