| NPI | 1568435469 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: UT 287230-1205) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX J2951) |
| Enumeration Date | 2006-02-10 |
| Last Update Date | 2008-07-03 |