| NPI | 1548477631 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: CA C199378) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA C199378) |
| 207X00000X Orthopaedic Surgery (Licence: PA MD441573) | |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2025-01-13 |