| NPI | 1245491182 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WI 71982) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA A124381) |
| 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: ND 13271) | |
| 207X00000X Orthopaedic Surgery (Licence: IA R-8448) | |
| Enumeration Date | 2008-06-23 |
| Last Update Date | 2019-12-06 |