| NPI | 1558771436 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: UT 11268149-1205) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX BP10049573) |
| Enumeration Date | 2014-05-01 |
| Last Update Date | 2019-06-12 |