| NPI | 1053606210 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX S6209) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: SC 83727) |
| 207X00000X Orthopaedic Surgery (Licence: HI MD-16476) | |
| Enumeration Date | 2011-06-16 |
| Last Update Date | 2023-08-11 |