| NPI | 1154503274 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: FL ME134381) |
| Additional Taxonomies | 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: TX P1933) |
| 207X00000X Orthopaedic Surgery (Licence: TX P1933) | |
| Enumeration Date | 2007-11-30 |
| Last Update Date | 2018-03-17 |