| NPI | 1396795167 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: AZ 67575) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WI 47367) |
| 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: AZ 678785) | |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2024-10-16 |