| NPI | 1356797435 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: NY 308627) |
| Additional Taxonomies | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: TX R9118) |
| 207X00000X Orthopaedic Surgery (Licence: TX BP10057654) | |
| Enumeration Date | 2016-05-09 |
| Last Update Date | 2025-09-03 |