| NPI | 1235110222 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: TX M1698) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX M-1698) |
| Enumeration Date | 2005-11-08 |
| Last Update Date | 2023-03-07 |