| NPI | 1265888515 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: AL 44193) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: AL 44193) |
| 207X00000X Orthopaedic Surgery (Licence: MO 2021017597) | |
| 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: MO 2021017597) | |
| Enumeration Date | 2016-05-05 |
| Last Update Date | 2024-05-07 |