| NPI | 1598228728 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: UT 13867736-1205) |
| Additional Taxonomies | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: UT 13867736-1205) |
| Enumeration Date | 2019-04-14 |
| Last Update Date | 2024-04-25 |