| NPI | 1851703938 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NY 306879) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: LA 320437) |
| 207X00000X Orthopaedic Surgery (Licence: TX BP10050665) | |
| Enumeration Date | 2014-05-23 |
| Last Update Date | 2026-07-06 |