| NPI | 1548776677 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX G6139) |
| Additional Taxonomies | 202C00000X Independent Medical Examiner (Licence: TX G6139) |
| Enumeration Date | 2017-12-27 |
| Last Update Date | 2017-12-27 |