| NPI | 1366735532 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: CO DR.0052482) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA A136846) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-05-20 |
| Last Update Date | 2022-03-07 |