| NPI | 1811372410 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: ID O-1394) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX S3807) |
| Enumeration Date | 2015-07-23 |
| Last Update Date | 2022-01-04 |