| NPI | 1457513012 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX p3853) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA A104320) |
| Enumeration Date | 2008-06-25 |
| Last Update Date | 2023-05-10 |