| NPI | 1316140536 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0801X Orthopaedic Surgery Orthopaedic Trauma (Licence: TX P0524) |
| Additional Taxonomies | 207XX0801X Orthopaedic Surgery Orthopaedic Trauma (Licence: PA MD442102) |
| Enumeration Date | 2007-06-06 |
| Last Update Date | 2011-12-02 |