| NPI | 1861649717 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX P6904) |
| Additional Taxonomies | 207QS0010X Family Medicine, Sports Medicine (Licence: TX P6904) |
| 207X00000X Orthopaedic Surgery (Licence: NM MD2012-0911) | |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: TX P6904) | |
| Enumeration Date | 2008-08-22 |
| Last Update Date | 2023-09-13 |