| NPI | 1407054208 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: VA 0101254138) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX P2759) |
| Enumeration Date | 2007-07-03 |
| Last Update Date | 2018-05-02 |