| 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 | 2024-11-01 |