| NPI | 1174596779 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XP3100X Orthopaedic Surgery Pediatric Orthopaedic Surgery (Licence: TX K3267) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX K3267) |
| Enumeration Date | 2006-02-13 |
| Last Update Date | 2012-02-14 |