| NPI | 1306339676 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: UT 13296088-1205) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MA 275513) |
| Enumeration Date | 2018-06-12 |
| Last Update Date | 2026-06-11 |