| NPI | 1457746794 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX T6577) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TN 63250) |
| Enumeration Date | 2015-04-03 |
| Last Update Date | 2022-09-20 |