| NPI | 1285833129 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: LA 320573) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MS T-1987) |
| 207X00000X Orthopaedic Surgery (Licence: TN MD48720) | |
| 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: TX P7970) | |
| 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: MS 23488) | |
| Enumeration Date | 2007-07-11 |
| Last Update Date | 2020-03-06 |