| NPI | 1316351836 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: AL 41190) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: AL 41190) |
| 207X00000X Orthopaedic Surgery (Licence: SC LL36963) | |
| Enumeration Date | 2014-06-12 |
| Last Update Date | 2020-09-03 |