| NPI | 1528440625 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: TX T0597) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MO 2015019411) |
| Enumeration Date | 2015-06-24 |
| Last Update Date | 2022-03-11 |