| NPI | 1780926816 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: MI 4301500248) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI 4301103246) |
| 207X00000X Orthopaedic Surgery (Licence: TX R7115) | |
| Enumeration Date | 2013-03-27 |
| Last Update Date | 2019-08-05 |