| NPI | 1124324058 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: TX Q9617) |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: TX Q9617) |
| Enumeration Date | 2011-02-10 |
| Last Update Date | 2016-08-23 |