NPI | 1588840102 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: TX S3531) |
Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: UT 7676044-1205) |
207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: GA 65463) | |
Enumeration Date | 2008-01-14 |
Last Update Date | 2025-06-12 |