| NPI | 1336148345 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: VA 0101281432) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY 309870) |
| 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: NY 309870) | |
| 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: VA 0101281432) | |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: VA 0101281432) | |
| Enumeration Date | 2005-07-20 |
| Last Update Date | 2024-04-09 |