| NPI | 1578720876 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX M9239) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NC 117304) |
| Enumeration Date | 2008-05-22 |
| Last Update Date | 2023-08-02 |