| NPI | 1194934307 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: OR MD159896) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OR MD159896) |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2025-08-18 |