| NPI | 1730204454 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: TX N2883) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OH 35.087415) |
| Enumeration Date | 2007-03-20 |
| Last Update Date | 2020-04-27 |