| NPI | 1194828343 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: KY 40531) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX K3647) |
| Enumeration Date | 2006-09-06 |
| Last Update Date | 2024-02-22 |