| NPI | 1801070842 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX Q0081) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MN 106957) |
| Enumeration Date | 2007-12-27 |
| Last Update Date | 2025-08-06 |