| NPI | 1346477676 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MI 4301117356) | 
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA 129788) | 
| 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: MI 4301117356) | |
| Enumeration Date | 2009-06-13 | 
| Last Update Date | 2020-02-25 |