| NPI | 1861505679 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX H3001) |
| Additional Taxonomies | 207XS0106X Orthopaedic Surgery, Hand Surgery (Licence: NM 75-14) |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2013-07-17 |