| NPI | 1811261985 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX R7366) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OH BM4400379242) |
| Enumeration Date | 2012-03-06 |
| Last Update Date | 2020-09-24 |