| NPI | 1396030680 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA A156721) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY 288700) |
| 207XP3100X Orthopaedic Surgery Pediatric Orthopaedic Surgery (Licence: TX Q8402) | |
| Enumeration Date | 2011-06-14 |
| Last Update Date | 2021-12-21 |