| NPI | 1841519212 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX R2115) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MD D81168) |
| Enumeration Date | 2010-05-25 |
| Last Update Date | 2023-06-05 |