| NPI | 1780978775 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX R4019) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MD D0096427) |
| Enumeration Date | 2011-06-07 |
| Last Update Date | 2026-01-19 |