| NPI | 1730161886 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX L0176) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TN 43514) |
| Enumeration Date | 2005-11-15 |
| Last Update Date | 2019-12-12 |