| NPI | 1497072995 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: TX Q3436)  | 
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX Q3436)  | 
| Enumeration Date | 2010-04-23 | 
| Last Update Date | 2018-07-26 |