| NPI | 1083692131 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NC 2006-01871) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX m1262) |
| Enumeration Date | 2006-01-07 |
| Last Update Date | 2013-01-04 |