| NPI | 1497790414 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: LA 343126) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX L6924) |
| 207X00000X Orthopaedic Surgery (Licence: OR MD219632) | |
| 207X00000X Orthopaedic Surgery (Licence: KS 04-41342) | |
| Enumeration Date | 2006-06-17 |
| Last Update Date | 2024-07-29 |