| NPI | 1821224700 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: TX P7152) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA a107409) |
| 207X00000X Orthopaedic Surgery (Licence: TX P7152) | |
| Enumeration Date | 2009-06-04 |
| Last Update Date | 2025-08-25 |