| NPI | 1184834111 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX S0240) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: LA 026506) |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2019-09-05 |