| NPI | 1083875827 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX P9527) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MA 254259) |
| 207X00000X Orthopaedic Surgery (Licence: CA A109579) | |
| Enumeration Date | 2008-06-24 |
| Last Update Date | 2020-04-27 |