| NPI | 1508184508 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: TX Q8798)  | 
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX Q8798)  | 
| Enumeration Date | 2010-05-14 | 
| Last Update Date | 2022-02-03 |