NPI | 1912353772 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: WA MD61315341) |
Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WA MD61315341) |
Enumeration Date | 2016-05-11 |
Last Update Date | 2022-09-08 |