| NPI | 1003255415 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: TX R3203) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA A125747) |
| Enumeration Date | 2013-06-19 |
| Last Update Date | 2024-07-01 |