| NPI | 1831325026 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: TX P4658) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA A106854) |
| Enumeration Date | 2009-06-02 |
| Last Update Date | 2023-10-17 |