| NPI | 1255532347 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX N2819) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WI 53789) |
| 207X00000X Orthopaedic Surgery (Licence: AZ 53970) | |
| Enumeration Date | 2007-05-29 |
| Last Update Date | 2021-09-01 |