| NPI | 1215131800 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX N7005) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA A114085) |
| 207X00000X Orthopaedic Surgery (Licence: CO DR.0071755) | |
| Enumeration Date | 2007-06-14 |
| Last Update Date | 2026-03-04 |