| NPI | 1740284140 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MO 112693) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: KS 0426908) |
| 207X00000X Orthopaedic Surgery (Licence: OK 20886) | |
| 207X00000X Orthopaedic Surgery (Licence: TX J3342) | |
| Enumeration Date | 2005-06-13 |
| Last Update Date | 2014-02-04 |