| NPI | 1346477452 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX P4009) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WA MD60433488) |
| Enumeration Date | 2009-06-16 |
| Last Update Date | 2022-04-06 |