| NPI | 1255301842 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA C142043) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX H6536) |
| Enumeration Date | 2006-01-25 |
| Last Update Date | 2016-10-06 |