| NPI | 1275780215 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX N0430) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA A94514) |
| 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: TX N0430) | |
| Enumeration Date | 2008-08-21 |
| Last Update Date | 2021-03-23 |