| NPI | 1659868842 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA OS022865) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX BP10063417) |
| Enumeration Date | 2018-04-13 |
| Last Update Date | 2023-10-20 |