| NPI | 1407153943 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OH 34.014743) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX Q0575) |
| 207X00000X Orthopaedic Surgery (Licence: OH 58.003469) | |
| Enumeration Date | 2011-02-18 |
| Last Update Date | 2021-11-19 |