| NPI | 1366418386 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: UT 4918951-1205) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX L5031) |
| Enumeration Date | 2006-02-28 |
| Last Update Date | 2022-04-25 |