| NPI | 1063491975 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX N2201) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MN 47732) |
| Enumeration Date | 2006-01-10 |
| Last Update Date | 2024-06-07 |