| NPI | 1033180922 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX J0098) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TN MD0000031271) |
| Enumeration Date | 2006-01-30 |
| Last Update Date | 2021-02-05 |