| NPI | 1104844943 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX K9904) |
| Additional Taxonomies | 207XX0801X Orthopaedic Surgery Orthopaedic Trauma (Licence: TX K9904) |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2021-11-29 |