| NPI | 1265881502 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX BP10057667) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: VA 0101274859) |
| Enumeration Date | 2016-06-07 |
| Last Update Date | 2022-05-11 |