NPI | 1790794592 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: TX L1237) |
Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX L1237) |
Enumeration Date | 2006-08-08 |
Last Update Date | 2025-04-29 |