| NPI | 1215974563 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: CA A87272) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MO 2005019591) |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2020-04-13 |