| NPI | 1316264484 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: TX P9353) | 
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX P9353) | 
| 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: LA 302885) | |
| Enumeration Date | 2010-04-28 | 
| Last Update Date | 2024-08-02 |