| NPI | 1831332576 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WI 76803-20) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX P9895) |
| Enumeration Date | 2009-04-10 |
| Last Update Date | 2022-08-02 |