| NPI | 1013972173 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: TX J3635) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX J3635) |
| Enumeration Date | 2006-04-19 |
| Last Update Date | 2022-07-13 |