| NPI | 1356498299 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX G8339) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: VA 101043615) |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2019-08-09 |