| NPI | 1558709774 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OH 34.013188) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX U3805) |
| 207X00000X Orthopaedic Surgery (Licence: KY 04236) | |
| Enumeration Date | 2013-06-10 |
| Last Update Date | 2023-07-21 |