| NPI | 1134447196 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX H9352) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX H9352) |
| Enumeration Date | 2010-05-14 |
| Last Update Date | 2010-12-23 |