| NPI | 1992909576 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX N5354) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX BP2-0026303) |
| Enumeration Date | 2007-06-14 |
| Last Update Date | 2014-10-13 |