| NPI | 1144515016 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OK 32109) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX 557686) |
| Enumeration Date | 2011-06-17 |
| Last Update Date | 2021-03-11 |