| NPI | 1588840102 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: UT 7676044-1205) |
| Additional Taxonomies | 207XP3100X Orthopaedic Surgery Pediatric Orthopaedic Surgery (Licence: GA 65463) |
| Enumeration Date | 2008-01-14 |
| Last Update Date | 2021-12-10 |