| NPI | 1841258175 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX P5305) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI 5101015054) |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2019-11-05 |