| NPI | 1023334372 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: VA 0101259977) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA A133797) |
| Enumeration Date | 2010-04-12 |
| Last Update Date | 2023-08-08 |