| NPI | 1639387061 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX P0833) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: IA R-7888) |
| Enumeration Date | 2007-05-18 |
| Last Update Date | 2016-11-02 |