| NPI | 1053816736 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: UT 13803554-1205) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX T0129) |
| Enumeration Date | 2018-03-26 |
| Last Update Date | 2024-08-09 |