| NPI | 1154783066 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: UT 12218054-1205) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: UT 12218054-1205) |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: NY 317527) | |
| Enumeration Date | 2016-03-22 |
| Last Update Date | 2023-07-22 |