| NPI | 1588897011 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery Adult Reconstructive Orthopaedic Surgery (Licence: TX Q5707) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX Q5707) |
| Enumeration Date | 2009-09-01 |
| Last Update Date | 2023-01-05 |