| NPI | 1538763883 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: FL 37574) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA 3624) |
| Enumeration Date | 2020-11-27 |
| Last Update Date | 2024-05-29 |