| NPI | 1073772950 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX BP10032049) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX Q0893) |
| Enumeration Date | 2008-06-05 |
| Last Update Date | 2019-06-04 |