| NPI | 1003377755 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NY 328251) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX BP10068342) |
| 207X00000X Orthopaedic Surgery (Licence: TX T2424) | |
| Enumeration Date | 2019-03-26 |
| Last Update Date | 2024-07-24 |