| NPI | 1326484403 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA 157487) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX BP10047227) |
| 207X00000X Orthopaedic Surgery (Licence: MT MED-PHYS-LIC-124304) | |
| Enumeration Date | 2013-05-16 |
| Last Update Date | 2024-02-19 |