| NPI | 1487042008 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: UT 9288037-1252) |
| Additional Taxonomies | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: UT 1234567-1205) |
| Enumeration Date | 2015-01-05 |
| Last Update Date | 2017-09-22 |