| NPI | 1093013500 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CO 51307) |
| Additional Taxonomies | 207XP3100X Orthopaedic Surgery Pediatric Orthopaedic Surgery (Licence: MO 2011006545) |
| Enumeration Date | 2011-03-08 |
| Last Update Date | 2021-04-09 |