| NPI | 1912974932 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NM MD2025-0614) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX H8521) |
| Enumeration Date | 2006-03-08 |
| Last Update Date | 2025-11-26 |