| NPI | 1275064560 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: LA 342231) |
| Additional Taxonomies | 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: MO 2022010832) |
| Enumeration Date | 2017-03-27 |
| Last Update Date | 2026-02-06 |