| NPI | 1235794967 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OH 35.150230) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX BP10067120) |
| Enumeration Date | 2019-05-08 |
| Last Update Date | 2024-06-23 |