| NPI | 1043415250 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX R0646) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MT184981) |
| 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: DE C7-0003655) | |
| 207X00000X Orthopaedic Surgery (Licence: AZ 41837) | |
| 208600000X Surgery (Licence: OH 35-095639) | |
| Enumeration Date | 2007-06-18 |
| Last Update Date | 2017-02-01 |