| NPI | 1316387392 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: MO 2023014623) |
| Additional Taxonomies | 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: KS 05-47742) |
| 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: TX T3546) | |
| Enumeration Date | 2013-07-05 |
| Last Update Date | 2026-08-27 |