| NPI | 1851590673 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MO 2013003539) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX P5073) |
| Enumeration Date | 2007-07-12 |
| Last Update Date | 2021-02-19 |