| NPI | 1316384316 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX R6135) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MS 25819) |
| Enumeration Date | 2013-05-30 |
| Last Update Date | 2023-03-07 |