| NPI | 1316107592 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: KY 47272) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX P4682) |
| Enumeration Date | 2008-06-11 |
| Last Update Date | 2020-12-06 |