| NPI | 1619916939 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: ID M-10077) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX R2871) |
| Enumeration Date | 2006-06-05 |
| Last Update Date | 2019-08-14 |