| NPI | 1396799326 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: VA 0101255163) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX H2382) |
| Enumeration Date | 2006-05-22 |
| Last Update Date | 2017-02-02 |