| NPI | 1265810725 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX R5711) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX BP10054320) |
| Enumeration Date | 2015-05-15 |
| Last Update Date | 2024-06-20 |