| NPI | 1215254156 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX P6377) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NV 15765) |
| 207X00000X Orthopaedic Surgery (Licence: CA A135648) | |
| Enumeration Date | 2010-05-03 |
| Last Update Date | 2020-09-08 |