| NPI | 1427498294 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: TX R6724) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NC 191862) |
| Enumeration Date | 2013-06-26 |
| Last Update Date | 2019-09-11 |