| NPI | 1952643744 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: OR MD205466) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OR MD205466) |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: TX R4094) | |
| Enumeration Date | 2013-03-20 |
| Last Update Date | 2024-10-22 |