| NPI | 1093851123 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: TX N7156) | 
| Additional Taxonomies | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: PA mt180035) | 
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: AZ 40390) | |
| Enumeration Date | 2007-01-29 | 
| Last Update Date | 2022-02-05 |