| NPI | 1568724771 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX R6680) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX BP10044122) |
| Enumeration Date | 2012-06-13 |
| Last Update Date | 2020-03-10 |