| NPI | 1497013544 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MI 4301510566) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX R9541) |
| Enumeration Date | 2012-04-26 |
| Last Update Date | 2023-11-07 |