| NPI | 1972579324 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX N1370) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 34.008422) |
| 207XS0106X Orthopaedic Surgery, Hand Surgery (Licence: TX N1370) | |
| Enumeration Date | 2006-02-27 |
| Last Update Date | 2012-06-26 |