| NPI | 1275692568 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX N6075) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: ND 7558) |
| Enumeration Date | 2006-12-06 |
| Last Update Date | 2020-06-24 |