| NPI | 1679527352 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX P1945) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: AR E3626) |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2015-10-23 |