| NPI | 1427362847 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: LA 205931) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX N7401) |
| Enumeration Date | 2010-07-27 |
| Last Update Date | 2015-12-23 |