| NPI | 1558706523 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: TX S4576) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MD461679) |
| 207X00000X Orthopaedic Surgery (Licence: NH LT4271) | |
| 207X00000X Orthopaedic Surgery (Licence: TX S4576) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-05-05 |
| Last Update Date | 2023-08-22 |