| NPI | 1003901539 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: LA 201019) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: LA 201019) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2025-01-17 |