| NPI | 1710938238 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: TX M2641) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX M2641) |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2014-11-06 |