| NPI | 1992755383 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: MO R2700) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MO R2700) |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2021-08-30 |