| NPI | 1942264106 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX L2934) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NM 78177) |
| Enumeration Date | 2006-04-14 |
| Last Update Date | 2019-02-01 |