NPI | 1760742324 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: PA MT201618) |
Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MT201618) |
Enumeration Date | 2012-05-16 |
Last Update Date | 2022-07-21 |