| NPI | 1073870572 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XP3100X Orthopaedic Surgery Pediatric Orthopaedic Surgery (Licence: IA MD-45131) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA A146856) |
| 207X00000X Orthopaedic Surgery (Licence: IA MD-45131) | |
| 207XS0117X Orthopaedic Surgery Orthopaedic Surgery of the Spine (Licence: IA MD-45131) | |
| Enumeration Date | 2012-04-20 |
| Last Update Date | 2018-11-01 |