| NPI | 1679833388 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: TX R8620) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX R8620) |
| Enumeration Date | 2012-05-29 |
| Last Update Date | 2023-12-20 |