| NPI | 1457798548 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX R7424) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI 4301114363) |
| 207X00000X Orthopaedic Surgery (Licence: TX BP10047046) | |
| Enumeration Date | 2013-05-29 |
| Last Update Date | 2019-09-15 |