| NPI | 1427463330 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: UT 11659143-1205) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NE 7303) |
| Enumeration Date | 2014-06-30 |
| Last Update Date | 2023-11-27 |