| NPI | 1750583910 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX P1389) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY 248584) |
| Enumeration Date | 2007-06-01 |
| Last Update Date | 2012-01-24 |