NPI | 1528412491 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: MO 2022035735) |
Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OR 177178) |
Enumeration Date | 2016-04-18 |
Last Update Date | 2022-09-13 |