| 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) |
| Enumeration Date | 2010-04-28 |
| Last Update Date | 2019-10-01 |