| NPI | 1548236748 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: TX R4716) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: VA 0101224432) |
| 207X00000X Orthopaedic Surgery (Licence: TX R4716) | |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: VA 0101224432) | |
| Enumeration Date | 2006-02-27 |
| Last Update Date | 2023-09-22 |