| NPI | 1720013519 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OR MD192188) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX F-1941) |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2020-11-04 |