| NPI | 1558666032 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA A135042) |
| Additional Taxonomies | 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: MA 279994) |
| 207X00000X Orthopaedic Surgery (Licence: MA 279994) | |
| Enumeration Date | 2011-01-14 |
| Last Update Date | 2020-06-10 |