| NPI | 1356651301 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX N7807) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MO 2012011142) |
| Enumeration Date | 2010-10-08 |
| Last Update Date | 2022-07-26 |