NPI | 1588733489 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: OR MD21219) |
Additional Taxonomies | 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: WA MD00036102) |
Enumeration Date | 2006-11-06 |
Last Update Date | 2022-02-04 |