| NPI | 1780681734 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: LA 13483R) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX K1214) |
| Enumeration Date | 2005-07-06 |
| Last Update Date | 2024-03-08 |