| NPI | 1336646876 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: UT 11420238-1205) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: UT 11420238-1205) |
| 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: PA MT228064) | |
| Enumeration Date | 2018-04-11 |
| Last Update Date | 2024-07-22 |