| NPI | 1639589732 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OK 46056) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX BP10050858) |
| Enumeration Date | 2014-04-29 |
| Last Update Date | 2025-11-28 |