| NPI | 1932629383 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX BP10061317) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX U8710) |
| 207X00000X Orthopaedic Surgery (Licence: WI 70772-20) | |
| Enumeration Date | 2017-06-26 |
| Last Update Date | 2024-11-07 |