| NPI | 1265494611 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX L7133) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX L7133) |
| 207X00000X Orthopaedic Surgery (Licence: NC 2006-00209) | |
| Enumeration Date | 2006-04-03 |
| Last Update Date | 2021-10-15 |