| NPI | 1497175210 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA MD474372) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: UT 11778289-1205) |
| 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: UT 11778289-1205) | |
| Enumeration Date | 2014-04-19 |
| Last Update Date | 2021-09-09 |