| NPI | 1346444916 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WA MD00047672) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX BP3-0020794) |
| Enumeration Date | 2007-06-14 |
| Last Update Date | 2019-01-17 |