| NPI | 1669631222 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX Q0326) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: ZZ 5384) |
| Enumeration Date | 2008-06-08 |
| Last Update Date | 2021-12-01 |