| NPI | 1811124910 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX BP10034018) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX P2096) |
| Enumeration Date | 2009-06-16 |
| Last Update Date | 2020-05-14 |