| NPI | 1437147998 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: TX H5356) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX H5356) |
| 207Q00000X Family Medicine (Licence: TX H5356) | |
| 207QS0010X Family Medicine, Sports Medicine (Licence: TX H5356) | |
| Enumeration Date | 2005-10-10 |
| Last Update Date | 2017-08-10 |