| NPI | 1811253453 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX S3316) |
| Additional Taxonomies | 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: TX S3316) |
| 207X00000X Orthopaedic Surgery (Licence: CA A154200) | |
| Enumeration Date | 2012-04-09 |
| Last Update Date | 2024-06-24 |