| NPI | 1790009264 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: UT 8153449-8905) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: UT 8153449-1205) |
| Enumeration Date | 2010-03-26 |
| Last Update Date | 2025-05-28 |