| NPI | 1801876115 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NM 94-221) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX K9248) |
| Enumeration Date | 2006-01-20 |
| Last Update Date | 2025-08-01 |