| NPI | 1295182632 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: TX T7715) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX T7715) |
| 207X00000X Orthopaedic Surgery (Licence: CO DR.0066320) | |
| Enumeration Date | 2016-05-16 |
| Last Update Date | 2022-08-04 |