| NPI | 1992970180 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: UT 6826233-1205) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: UT 6826233-8905) |
| Enumeration Date | 2008-04-28 |
| Last Update Date | 2014-02-27 |