| NPI | 1578889200 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NC 2016-00336) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX BP10037398) |
| Enumeration Date | 2010-04-20 |
| Last Update Date | 2020-10-25 |