| NPI | 1992865869 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX N9364) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MT186006) |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: HI 19786) | |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2022-12-20 |