| NPI | 1780979575 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: UT 12042508-1205) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX R2707) |
| Enumeration Date | 2011-06-09 |
| Last Update Date | 2024-12-16 |