| NPI | 1194014258 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: TX T2124) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MD 09041985) |
| 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: MS 25001) | |
| 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: CA A139710) | |
| Enumeration Date | 2011-03-29 |
| Last Update Date | 2021-08-23 |