| NPI | 1164626735 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX N8119) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX BP1-0026302) |
| Enumeration Date | 2007-06-14 |
| Last Update Date | 2022-04-27 |