| NPI | 1447647599 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX T1491) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NC 2020-00228) |
| Enumeration Date | 2015-04-15 |
| Last Update Date | 2022-03-14 |