| NPI | 1326571969 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: CA 20A19988) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA 20A19988) |
| Enumeration Date | 2017-04-11 |
| Last Update Date | 2025-10-03 |