| NPI | 1790776821 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX F4188) |
| Additional Taxonomies | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: TX F4188) |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: TX F4188) | |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: TX F4188) | |
| Enumeration Date | 2005-10-28 |
| Last Update Date | 2012-09-28 |