| NPI | 1497872774 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX M1570) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NC 2007-00754) |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: NC 2007-00754) | |
| Enumeration Date | 2007-03-23 |
| Last Update Date | 2022-11-21 |