| NPI | 1083946685 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: TX Q0747) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX Q0747) |
| Enumeration Date | 2010-02-05 |
| Last Update Date | 2021-11-09 |