| NPI | 1770879843 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: AZ 008371) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX R3726) |
| Enumeration Date | 2011-06-27 |
| Last Update Date | 2022-11-29 |