| NPI | 1467710186 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WA MD60827356) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX BP10043276) |
| Enumeration Date | 2012-05-01 |
| Last Update Date | 2021-06-02 |