| NPI | 1538579214 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX S4902) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NV 18473) |
| Enumeration Date | 2014-05-02 |
| Last Update Date | 2021-01-22 |