| NPI | 1184656282 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX Q2386) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NH 12405) |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2021-03-25 |