| NPI | 1104845569 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: NV 18506) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA G75995) |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2023-03-07 |