| NPI | 1225324387 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: FL FM6765018) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OR PG169070) |
| Enumeration Date | 2011-06-27 |
| Last Update Date | 2022-07-21 |