| NPI | 1396305371 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MO 2025029952) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX U8823) |
| Enumeration Date | 2019-06-20 |
| Last Update Date | 2025-08-06 |