| NPI | 1548246309 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NY 158612) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX H9647) |
| Enumeration Date | 2005-12-22 |
| Last Update Date | 2022-10-06 |